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Ganglioneuroma masquerading as spinal pain
Melanie D Osterhouse1, Norman W Kettner, Patrick T Birrer
1Department of Radiology, Logan College of Chiropractic, Chesterfield, Mo 63006-1065, USA.
Objective:
To discuss the clinical features of ganglioneuroma and to propose it as a differential diagnosis for a young patient suffering from chronic back pain.
Clinical Features:
A 25-year-old patient suffered from chronic mid-thoracic pain and a history of scoliosis. The physical examination result was unremarkable; thus radiographs were obtained. A posteroanterior and lateral chest radiograph demonstrated a well-defined opacity extending from the region of the left hilum to below the diaphragm. A differential diagnosis of a posterior mediastinal mass was advanced. Computed tomography revealed a homogenous, nonenhancing left posterior mediastinal mass with adjacent posterior rib deformity. Computed tomography (CT)-guided biopsy subsequently defined the mass as a ganglioneuroma.
Intervention And Outcome:
The mass was surgically resected. Although the patient experienced some postsurgical discomfort, she has fared well.
Conclusion:
Twenty percent of mediastinal tumors are neurogenic, and 10% of neurogenic tumors are ganglioneuromas. In spite of the rarity of this tumor, ganglioneuroma should be considered in the differential diagnosis of young patients suffering from back pain. The diagnosis is important to ascertain because surgical resection is curative and can relieve the symptoms.